Maternal, Perinatal and Pediatric Nutrition
Objective: This study aims to assess the effects of breastfeeding (BF) and Gestational Diabetes Mellitus (GDM) on the prevalence of the Metabolic Syndrome (MetS) in Hispanic children (10-19 years of age). We hypothesized that BF will be linked to decreased MetS risk in offspring of mothers with and without GDM.
Methods: Data is from a 12-year longitudinal study with 229 overweight or obese Hispanic children (10-19 years of age) with family history of Type 2 Diabetes and an average of four annual visits (AVs). Retrospective data on GDM status, BF duration, and birth weight were collected from mothers at the baseline visit via a parent questionnaire. For this analysis, MetS was defined based on the Adult Treatment Panel III criteria modified for children. Participants with MetS were classified into three groups: Never (negative for MetS at all AVs); Intermittent (positive for MetS at 1 or 2 AVs); and Persistent (positive for MetS at ≥3 AVs). The following measures were collected at each annual visit: Tanner stage via healthcare provider examinations, weight, height, waist circumference, blood pressure, total body fat via DEXA, and 2-hour oral glucose tolerance tests provided blood glucose values, Hemoglobin A1C, and lipid panel. Multinomial logistic regression was used to evaluate the effects of BF, GDM, and BF-GDM interaction on the prevalence of MetS at the child’s final annual visit with gender, Tanner stage, total body percent fat, and birth weight as covariates. All analyses were performed with SAS, version 9.4.
Results: There was a significant BF*GDM interaction on the prevalence of intermittent and persistent MetS (p < 0.05). Compared to non-GDM offspring who were BF, non-GDM offspring not BF, GDM offspring who were BF and GDM offspring not BF, all had increases in the prevalence of persistent MetS (OR=19.4, 95%CI: 5.9-63.5, p < 0.001; OR=4.5, 95%CI: 1.0-21.6, p < 0.001; OR=32.6, 95%CI: 8.2-129.6, p < 0.001). Among GDM offspring, those who were BF compared to those not BF had significantly lower prevalence of persistent MetS (OR=0.03, 95% CI: 0.01-0.3, p < 0.05).
Conclusions: These findings suggest that BF is protective against the prevalence of MetS in offspring with and without GDM. These finding suggest that the beneficial effects of BF may help decrease the deleterious effects of GDM on health outcomes in the offspring in this population.